Successful Application of Closed-Loop Artificial Pancreas Therapy After Islet Autotransplantation. Am J Transplant 2016 Feb;16(2):527-34
Date
11/21/2015Pubmed ID
26588810Pubmed Central ID
PMC4844547DOI
10.1111/ajt.13539Scopus ID
2-s2.0-84957967287 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
Total pancreatectomy with islet autotransplantation (TPIAT) may relieve the pain of chronic pancreatitis while avoiding postsurgical diabetes. Minimizing hyperglycemia after TPIAT limits beta cell apoptosis during islet engraftment. Closed-loop (CL) therapy combining an insulin pump with a continuous glucose monitor (CGM) has not been investigated previously in islet transplant recipients. Our objective was to determine the feasibility and efficacy of CL therapy to maintain glucose profiles close to normoglycemia following TPIAT. Fourteen adult subjects (36% male; aged 35.9 ± 11.4 years) were randomized to subcutaneous insulin via CL pump (n = 7) or multiple daily injections with blinded CGM (n = 7) for 72 h at transition from intravenous to subcutaneous insulin. Mean serum glucose values were significantly lower in the CL pump group than in the control group (111 ± 4 vs. 130 ± 13 mg/dL; p = 0.003) without increased risk of hypoglycemia (percentage of time <70 mg/dL: CL pump 1.9%, control 4.8%; p = 0.46). Results from this pilot study suggest that CL therapy is superior to conventional therapy in maintaining euglycemia without increased hypoglycemia. This technology shows significant promise to safely maintain euglycemic targets during the period of islet engraftment following islet transplantation.
Author List
Forlenza GP, Nathan BM, Moran AM, Dunn TB, Beilman GJ, Pruett TL, Bellin MDAuthor
Ty Blink Dunn MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultBlood Glucose
Case-Control Studies
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Humans
Hypoglycemia
Islets of Langerhans Transplantation
Male
Middle Aged
Pancreas, Artificial
Pancreatectomy
Pancreatitis, Chronic
Pilot Projects
Postoperative Complications
Prognosis
Risk Factors
Transplantation, Autologous
Young Adult
